When they finally resumed routine inspections of abortion clinics last year after more than 15 years, Pennsylvania health regulators ordered 14 of the state's 22 freestanding clinics to remedy problems, a review of records shows.
But none of the conditions found remotely approached the filthy and illegal operations described at the now-shuttered Philadelphia women's clinic presided over by a doctor who faces eight counts of murder related to his work there.
The grand jury that investigated Dr. Kermit Gosnell, his wife and eight other clinic workers had scathing criticism last week for Pennsylvania's state health and medical regulators for allowing the conditions at Gosnell's Women's Medical Society to exist unchecked for years.
The most common deficiencies found by Health Department inspectors at the other abortion clinics, according to records obtained by The Associated Press, were failures to properly report medical conditions that qualify as "serious events" and not keeping resuscitation equipment readily available. Also cited were failures to test or record urine protein and blood sugar levels, and issues related to checking on patients after surgery, in the recovery room.
Prosecutors blamed "a complete regulatory collapse" for allowing Gosnell's routine late-term abortions for poor women, mostly minorities. They described a "house of horrors," with discarded fetuses, bloody floors and furniture, dismembered baby parts stored in jars and staff with little or no training acting as doctors and nurses.
Prosecutors said at least two women died and hundreds of babies were killed by scissors stabbed into their spines; Gosnell was charged with murder in the deaths of one woman and seven babies born alive.
"Gosnell and his staff severed the spinal cords of viable, moving, breathing babies who were born alive," the grand jury said.
Gosnell said at his arraignment last week that he did not understand why he was being charged in the deaths of the babies. "He told his staff that this barbaric conduct was standard medical practice. It was not. It was criminal behavior," the grand jury said. Gosnell was jailed without bail.
It wasn't until after a drug raid in February 2010 that revealed conditions at Gosnell's clinic that the State Health Department resumed regular abortion clinic inspections. The grand jury said those inspections had ended about 1995 for political reasons, to avoid barriers for women seeking abortions.
Gov. Tom Corbett, who took office last week, has asked his nominees for secretaries of health and state to look into the criticism that the state ceased routine inspections for political reasons when Gov. Tom Ridge became governor in 1995, a policy that continued under Govs. Mark Schweiker and Ed Rendell. Their report is not yet complete, a spokeswoman for Corbett said Tuesday.
The new inspections resulted in letters to six clinics in Pittsburgh, five in Philadelphia, three in Allentown and clinics in East Liberty, Upland, York, West Chester, Harrisburg, Reading, Norristown and Warminster. Eight of the letters said the clinics were operating in full accordance with state law.
Other issues cited included not monitoring or documenting blood pressure, pulse and oxygen levels; too much ice crusted inside a freezer for medication and not examining tissue from all first-trimester abortions, as required, to see if the women were pregnant.
The Allentown Women's Center changed its equipment provider and obtained preventive maintenance to address problems with material past its expiration date, said executive director Jennifer Boulanger.
The Allentown facility was also cited for having its patient safety committee meet only three times a year, not quarterly, a minor distinction that points out the detailed nature of the inspection, conducted by a team of four people over the course of a day in March, Boulanger said.
"We want to have the highest medical standards for our patients, so we welcome their inspections," she said. "Pennsylvania has good regulations — they just weren't enforced every year."
Planned Parenthood of Western Pennsylvania was cited for a lack of written evidence that its physicians had to supervise the licensed practical nurses working in the recovery room. It responded by simply updating doctors' job descriptions to specify that was their duty, said chief executive Kim Evert.
"That was the end of it," Evert said. "We don't have any problem with the state inspecting on a regular basis."
In a September visit to the Hillcrest Women's Medical Center in Harrisburg, equipment was found well past expiration date. Also found was an unlabeled bag of blue pills and practices that raised patient confidentiality concerns.
"It was noted that names of patients that were having procedures that day were displayed on the wall in the hallway where they could be observed by other patients," the agency wrote.
Hillcrest administrator Maria Friel, the recipient of the state's letter, did not respond to phone messages seeking comment. The center was ordered to submit a written plan within 10 days to address the problems.
The Planned Parenthood Association of Bucks County immediately altered its recovery room monitoring protocol after it was cited by inspectors in a Nov. 9 visit, then submitted a plan of correction that the state accepted, said Maggie Groff, public affairs director for the association.